左傍十二指腸ヘルニアの1例

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  • A CASE OF LEFT PARADUODENAL HERNIA

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We encountered a patient left paraduodenal hernia. A 45-year-old male had been suffering from an occasionally developed upper abdominal pain for 12 years. He was seen at the visited our hospital because of an upper abdominal pain and vomiting 7 years before, when close examination showed no findings and the symptoms improved. Subsequently, intermittent abdominal pain developed but improved in a short time. This time, he was admitted to the hospital because of a marked upper abdominal pain. Plain X-ray examination of the abdomen revealed niveau of the small intestine in the left upper abdomen. CT scanning also showed a cystic accumulation image of the small intestine at the same site. A diagnosis of strangulation ileus was made, and laparotomy was performed. A left paraduodenal hernia was observed. The hernial content was reduced, and the hernial orifice was closed.<br> There are 81 reported patients with paraduodenal hernias including ours in Japan. The disease occurs in a low incidence and often demands an emergency operation. However, since characteristic findings are present, the preoperative diagnosis of paraduodenal hernias can be made by taking into consideration the possibility of this disease.

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